Tag Archives: family physician

This year, instead of receiving a written invitation to my 10-year high school reunion, I got a Facebook invite. My classmates from Honolulu, Hawaii are scattered across the US, overseas, and work in countless different fields. When I think of what family medicine will look like in 10 years, I imagine what this year’s Class of 2017 is going to do in the world. They will be the family physicians that will shape our specialty’s direction, and I am very excited to see what they do.

Every summer, our residency program sponsors a pipeline program for high school students interested in health care careers. Many of them are considering family medicine. These students are from a high school near the San Diego/Mexico border with traditionally low graduation rates, and most are bilingual and the first in their families to even think about college. Daily activities are run by undergraduates in pre-medical studies and a second-year medical student from the community. We residents get to present to the students on topics they request. One of these was “health issues affecting teens” and I chose to talk about mental health and suicide prevention.

Stepping into that classroom energized me. The students were engaged and open. They asked questions and shared personal experiences about friends and family members with mental illness. At the end of the lesson, when we discussed how to recognize and help a suicidal peer, many asked about volunteering in suicide hotlines. They demonstrated insight into the issue of mental illness in their community, a desire to help, and awareness of how to make that impact.

Using that microcosm, I believe that family medicine in 10 years will be open to sharing ideas and engaging patients, communities, and other medical professionals to improve health. The Class of 2017 has grown up in an era of increased global and national awareness and changing demographics. Technology is a natural extension of relationships and they have learned to communicate through text, e-mail, Facebook, Instagram, Skype, Snapchat, YouTube, Twitter, Reddit, and more. In a 2015 Pew survey, 92% of teens reported going online daily.1 The result is a constant sharing of ideas, and a recognition that this world is both larger and smaller than previous generations realized. Celebrities and world leaders share their inner thoughts and everyday routines, while millions view viral videos of baby animals sneezing and police shootings. These virtual channels reveal a shared human experience that has shown future family physicians that we are all connected. More than that, these channels give family medicine a unique mechanism to better care for our patients and communities.

In 10 years, family medicine will be pioneering better ways to bring prevention and health maintenance to everyday life. Others in this blog have written about technology in the form of the electronic medical record and big data, which are important in optimizing our healthcare system. However, the Class of 2017 will change health culture as well. They will e-mail patients, share healthy recipes on social media, and weigh in on public health issues by writing blogs and doing video interviews. The culture of health will be one of openness that recognizes that healthcare is only responsible for 10% of health; people’s social networks, everyday routine, and resources matter much more.

Our residency’s summer program is one of many pipeline projects that will bring more diversity into our field. These future physicians from different backgrounds will recognize shared issues affecting patients and seek solutions based on interconnectedness, searching for possible solutions through peer networks or building on pilot projects involving health care teams. The awareness that a single physician or a single patient is not insular already exists and the next ten years will be full of learning on how to harness the capability of social networks to improve health and healthcare.

Family medicine will always be primary care. In 10 years, we will still act as the first person patients touch within the medical system, and serve as the principle coordinator of medical activities. What will continue to evolve is our awareness of the many factors affecting health and our willingness to engage with patients outside of 15-minute visits. In ten years, I see family physicians sharing ideas worldwide from California to New Zealand, and better understanding our patients’ lives through increased communication. And, at the Class of 2017’s ten-year reunion, I would love to hear their predictions for the Class of 2027.

By Matthew Martin, PhD and the members of the STFM Group on Addictions

A Prince in Crisis

On April 21, at 9:43 am, the Carver County Sheriff’s Office received a 911 call requesting that paramedics be sent to Paisley Park. The caller initially told the dispatcher that an unidentified person at the home was unconscious, then moments later said he was dead, and finally identified the person as Prince. The caller was Andrew Kornfeld, the son of Howard Kornfeld, MD, an addiction medicine specialist from Mill Valley, CA. Andrew, a pre-med student, had flown to Minneapolis with buprenorphine that morning to devise a treatment plan for opioid addiction. Emergency responders tried to revive the musician but later pronounced him dead at 10:07 am.

On April 20, the day before, Prince’s representatives contacted Dr Kornfeld, who agreed to see Prince later that week. Dr Michael Schulenberg, a family physician in Minneapolis, saw Prince on April 7 and April 20 apparently for opioid withdrawal. However, Dr Schulenberg is not a waivered physician and thus could not prescribe buprenorphine. If he had, perhaps Prince would now be recovering in a comfortable treatment center in California receiving state-of-the-art medical care. He would likely be receiving buprenorphine treatment to prevent opioid withdrawals. Recent autopsy results show that Prince died from an accidental overdose of Fentanyl.

Domestic violence, also known as intimate partner violence (IPV), is a reality everywhere—it happens to the rich and poor, men and women, and to all ethnicities. One in three women have some experience with IPV during their lifetime, and one in 10 men experience it. One in four have experienced severe physical violence by an intimate partner.